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Andrew C Crichton, Annalise Abbott; Perioperative course and midterm follow-up of FP8 (pediatric) Ahmed glaucoma valves in adults. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2707.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine the safety and efficacy of the surgical implantation of FP8 Ahmed Glaucoma Valves in adult patients focusing on three cohorts consisting of 1. patients over the age of 85, 2. patients who have had a previous Ahmed valve implanted in addition to the FP8, and 3. patients who have only had the FP8 and are under the age of 85.<br />
Methods: A retrospective review of the medical records of 47 patients over the age of 18 (49 eyes) who underwent FP8 Ahmed Glaucoma Valve implant surgery by Dr. Andrew Crichton in Calgary, Alberta with a minimum of six months follow-up. Preoperative, intraoperative and postoperative data was recorded including age, ocular history, best-corrected visual acuity, intraocular pressure (IOP), number of glaucoma medications and surgical complications or reoperations. Outcome measures include change in IOP, visual acuity, number of glaucoma medications and complications related to surgery. Two-tailed Student’s t-test was used for statistical analysis.<br />
Results: Of the 47 patients reviewed, 23 were male and 24 were female with a mean age of 74.4±17.5 years. IOP was reduced in the total patient group from a mean of 24.6±7.5mmHg (n=49) at baseline to 17.8±4.9mmHg at 6 months (n=48, P<0.001), 16.9±5.9mmHg at 12 months (n=33, P<0.001) and 16.3±5.7mmHg at 18 months (n=21, P<0.001). The number of glaucoma medications decreased from a mean of 3.3±1.2 (n=49) to 1.6±1.4 at 6 months (n=48, P<0.001), 1.5±1.3 at 12 months (n=33, P<0.001) and 1.8±1.4 at 18 months (n=21, P<0.001). Visual acuity in the operative eye decreased from baseline at 6 months by a mean of 1.1±2.4 lines (n=48), 0.7±2.6 lines at 12 months (n=33) and 0.8±2.1 lines at 18 months (n=21). Statistically significant decreases in IOP and number of glaucoma medications were also seen at all visits in the three cohorts. Two patients required additional glaucoma surgery to control pressures. The immediate post-operative course was relatively stable with mean IOPs between 10.7-12.7mmHg in the first week.<br />
Conclusion: The FP8 Ahmed Glaucoma Valve appears to be a viable device for the surgical management of glaucoma in adults. Potential advantages include fewer complications due to the smaller endplate and its use as an adjunctive therapy. The results indicate it can be effective in the three cohorts; advanced age, secondary valve implantation and primary valve implantation.<br />
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